Struggling With Infertility? The Top 8 Ways To Support Fertility + The Functional Medicine Labs You Need To Know About

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Infertility is unfortunately a common concern that comes up in my functional medicine telehealth practice. According to the World Health Organization, upwards of 17.5% of the world’s population struggles with infertility at some point in their lives. (1)

As a functional medicine practitioner, it is my job in these cases to help people take back control of their health by uncovering the underlying hormone imbalances and other root causes holding them back from conceiving.

If you’re struggling with infertility, read on to learn more about overlooked causes, the best labs you can run, and my favorite remedies for boosting fertility naturally.

What Causes Infertility?

The CDC defines infertility as not being able to get pregnant after at least one year or longer of having unprotected sex. (2) While there is no single cause of infertility, many factors can contribute to people not being able to conceive, including various environmental and lifestyle factors.

  • Chronic health problems: Existing conditions like polycystic ovary syndrome (PCOS) can inhibit ovulation.
  • Uterine or cervical abnormalities: Structural issues in the uterus or cervix can hinder conception or implantation.
  • Fallopian tube damage or blockage: Scar tissue, infections, or endometriosis can obstruct the fallopian tubes, preventing the egg from meeting the sperm.
  • Hormone imbalances: Imbalances between various hormones (and not just sex hormones) in both men and women can inhibit ovulation and sperm quality.
  • Gut health imbalances: Gut dysbiosis can lead to hormonal imbalances and make it harder to conceive.

Functional Medicine Fertility Labs

In functional medicine, we understand that everyone’s biochemistry is unique. Just because you have the same symptoms and health issues as someone else, it doesn’t mean the underlying cause is the same.

That’s why, if you’re experiencing unexplained infertility, I recommend specialized testing to help get to the root of the problem. These are some of the foundational labs I often start with, and depending on your specific case, different or additional tests may be recommended.

1. Cortisol

Stress and chronically high cortisol levels can mess with your hypothalamic-pituitary-gonadal (HPG) axis, responsible for controlling reproductive hormone production.

When this happens, it can inhibit the release of gonadotropin-releasing hormone from your hypothalamus (responsible for producing sex hormones like testosterone, estrogen, and progesterone), as well as the production of luteinizing-hormone (necessary for ovulation) and follicle-stimulating hormones (ensures optimal function of the ovaries and testes).

To determine just how much stress is impacting your fertility, I typically run a 24-hour adrenal stress index. This salivary test tracks your cortisol throughout a whole day to get the most accurate look at your overall cortisol levels.

2. Sex Hormones

Your body relies on a specific balance of the sex hormones estrogen, progesterone, and testosterone (alongside other hormones) to facilitate various aspects of fertility, including sperm production, ovulation, and conception.

If this balance is thrown off, infertility may occur, which is why it’s important to test your hormone levels.

For estrogen and progesterone I like to run a full blood and salivary hormone panel, including all estrogen isomers, and for testosterone I like to run a blood and saliva testosterone and DHEA panel.

3. Blood Sugar

Blood sugar levels have been linked to a variety of different hormone problems, including PCOS, which is the most common cause of female infertility. In fact, women with PCOS are often insulin resistant and have an increased risk for type 2 diabetes. (3)

Therefore, I always make sure to assess blood sugar levels with a combination of tests including serum insulin, c-peptide, fasting blood sugar, and HgbA1c.

4. Toxin Labs

It’s no secret that we live in a toxic world. Xenoestrogens, synthetic compounds that are found in many everyday products including pesticides, plastics, and personal care products, are classified as an endocrine disruptor (4). This is because they can mimic estrogen and bind to estrogen receptor sites in your body, leading to a cascade of hormone imbalances that end up affecting your fertility.

Multiple studies are also pointing to mold exposure as another potential contributing factor for infertility. For example, two studies published in Toxins found that certain mycotoxins (the toxic compounds produced by certain types of mold) impacted male fertility and contributed to female infertility, PCOS, and pregnancy loss. (5, 6)

For many of my patients struggling with fertility issues, I will suggest ​​mycotoxin labs to look for the presence of mycotoxins in your urine. Depending on your personal health profile, I may also recommend heavy metal and other toxin labs to determine if you have any consistent exposure to certain toxins.

READ MORE: How To Test For Mold Exposure | Dr. Will Cole 

5. Thyroid Panel

Imbalances in thyroid hormones can affect fertility in a number of ways. For example, hypothyroidism (low levels of thyroid hormones) can disrupt ovulation and the menstrual cycle, making it harder to conceive, and hyperthyroidism (excess thyroid hormones) can interfere with sperm quality.

Thyroid hormone imbalances also tend to be connected to other hormonal imbalances, so a thyroid panel helps to give us a more complete picture.

READ MORE: Guide To Thyroid Support Supplements & Diet | Dr. Will Cole 

6. Gut Microbiome Testing

Gut dysbiosis (an imbalance between beneficial and harmful bacteria in the gut microbiome) can disrupt hormonal balance and trigger inflammation throughout the body, all of which can affect fertility. Research has shown that dysbiosis is associated with infertility and related conditions including PCOS and endometriosis. (7)

In general, gut microbiome testing is a great window into what’s going on in your body, and offers a lot of insights into how to bring things back into balance.

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Natural Ways To Improve Fertility

A functional medicine approach recognizes that everyone’s case is unique, so specific recommendations for improving fertility can vary. But with that said, these are some of my favorite tools for boosting fertility holistically.

1. Manage Your Blood Sugar

Knowing that high blood sugar is so closely tied with PCOS and other hormone imbalances, stabilizing your blood sugar should be a priority.

Food is an integral piece of the blood sugar puzzle, and is best managed with a diet focused on reduced sugar consumption and clean, whole foods that are high in healthy fats and clean protein. To learn more about the best foods to eat for PCOS and hormone imbalance, check out my article here.

2. Try Acupuncture

Acupuncture, a staple in Traditional Chinese Medicine (TCM), has long been used as a natural fertility treatment and has been shown in many studies to significantly increase pregnancy rates in women with unexplained fertility. (8)

A systematic review published in the Chinese Journal Of Integrated Medicine found that acupuncture may be successful in boosting fertility because of its ability to improve ovulation through balancing and regulating the endocrine system, metabolism, and ovarian blood flow. (9)

3. Correct Any Nutritional Deficiencies

Multiple studies have found links between infertility and deficiencies in micronutrients like Vitamin D, Vitamin B12, folate, and zinc. (10-13)

Depending on the specific nutrients that are lacking and other individual factors, correcting deficiencies will often involve a combination of food sources and supplements.

My supplements The D3-K2 and The Methylator provide highly bioavailable forms of Vitamin D, and Vitamin B12 and folate, respectively, for maximum absorption. You can also find zinc, B12, and folate, as well as several other supportive vitamins, minerals, and amino acids, in my Gut Feelings blend.

4. Eat an Anti-Inflammatory Diet

Food is foundational when it comes to supporting fertility, preconception and prenatal health, egg quality, and overall wellness. As I’ve already touched on, it’s important to focus on clean, whole foods. Try to consume a wide variety of plant foods to ensure you’re taking in plenty of different supportive micronutrients, antioxidants, and phytonutrients.

Make sure you’re getting lots of omega-3 fatty acids, which are found in fatty fish like salmon and mackerel, as well as plant sources including flaxseeds and walnuts (you can also take a fish oil supplement if you need extra support).

The Mediterranean diet is often recommended as a balanced, anti-inflammatory diet template. I love that this diet focuses on whole foods and variety; however, for many people grains and dairy (which are included in this diet) can trigger inflammation. Ultimately, you have to find the way of eating that feels best for you (an elimination diet can help with this).

5. Go Non-Toxic

Making the switch to non-toxic beauty and cleaning products is one of the best lifestyle changes you can make to naturally boost your fertility. By eliminating as many endocrine disrupting chemicals as possible, you are giving your body a break from constantly having to be on the defense against these chemicals.

You can also support your liver (your body’s main detox organ) with supplements like milk thistle to enhance your body’s natural detoxification process.

6. Try Natural Supplements

In addition to the micronutrients mentioned above, certain natural supplements have been used for years around the world for female reproductive health, and have shown a lot of promise in recent clinical studies for boosting fertility.

  • Bee pollen: A nutritional powerhouse, one study found that regular supplementation of bee pollen was able to boost women’s chances of getting pregnant by 40% after just 9 months. (14)
  • Chastetree berry: Often used as a treatment for severe PMS and PMDD, studies also show that it can be beneficial for both male and female infertility. (15) Chastetree extract is included in my Balance supplement.
  • Myo-inositol: A common supplement for PCOS, myo-inositol is so effective that in one controlled trial, researchers found that women taking myo-inositol supplements achieved a natural pregnancy rate of 30% over a 6-month period compared to just 18% on metformin, a diabetes drug that has become the go-to treatment for PCOS in the conventional medicine world. (16) You can find myo-inositol in Chill.
  • Black cohosh: Studies have linked this herb to a significant improvement in pregnancy rates for those struggling with PCOS-related infertility. (17) Black cohosh is included in Thrive.

7. Heal Your Stress Response

This is often easier said than done, but it is definitely one of the best things you can do to boost your fertility. Stress can be a root cause of infertility, and healthy stress management is important for overall well-being.

Since chronic stress leads to sky high cortisol levels that can throw all of your sex hormones out of whack and drive up inflammation, it’s imperative to start addressing stress and your stress response as much as possible.

Make JOMO (the joy of missing out) a regular practice, reevaluate unhealthy relationships, and start implementing mindfulness practices like breathwork, yoga, journaling, or meditation.

8. Support Gut Health

Supporting a healthy environment in your gut is essential for hormone balance, wellness, and fertility. Many things we’ve already talked about, like eating an anti-inflammatory diet and dealing with chronic stress, will help here.

You may also want to add a high quality probiotic supplement to your routine, and incorporate probiotic and prebiotic foods into your eating plan. Depending on what comes up in gut microbiome testing, a functional medicine practitioner may have more individualized recommendations to get your microbiome into balance.

Seeking Help From a Functional Medicine Expert

Ultimately, everyone’s journey with fertility is unique. As a functional medicine expert, my job is to help you uncover the underlying causes behind your fertility struggles and put you on a path toward healing. From specialized lab testing to a comprehensive health history, my telehealth functional medicine team and I specialize in personalized functional medicine care for your whole mind and body health.

If you are struggling with infertility and looking for a more holistic approach, schedule a telehealth consultation today to learn more about how we can help you with functional medicine.

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  1. World Health Organization "1 in 6 people globally affected by infertility: WHO" Accessed December 2023. https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility
  2. Centers for Disease Control and Prevention "Infertility FAQs" Accessed December 2023. https://www.cdc.gov/reproductive-health/infertility-faq/
  3. Centers for Disease Control and Prevention "PCOS (PCOS (Polycystic Ovary Syndrome) and Diabetes)" Accessed December 2023. https://www.cdc.gov/diabetes/risk-factors/pcos-polycystic-ovary-syndrome.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/basics/pcos.html
  4. Reddy, V., McCarthy, M., & Raval, A. P. (2022). Xenoestrogens impact brain estrogen receptor signaling during the female lifespan: A precursor to neurological disease?. Neurobiology of disease, 163, 105596.
  5. El. Khoury, D., Fayjaloun, S., Nassar, M., Sahakian, J., & Aad, P. Y. (2019). Updates on the effect of mycotoxins on male reproductive efficiency in mammals. Toxins, 11(9), 515.
  6. Kinkade, C. W., Rivera-Núñez, Z., Gorcyzca, L., Aleksunes, L. M., & Barrett, E. S. (2021). Impact of fusarium-derived mycoestrogens on female reproduction: A systematic review. Toxins, 13(6), 373.
  7. Wang, M., Zheng, L. W., Ma, S., Zhao, D. H., & Xu, Y. (2024). The gut microbiota: emerging biomarkers and potential treatments for infertility-related diseases. Frontiers in Cellular and Infection Microbiology, 14, 1450310.
  8. Guven, P. G., Cayir, Y., & Borekci, B. (2020). Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: a randomized controlled trial. Taiwanese Journal of Obstetrics and Gynecology, 59(2), 282-286.
  9. Huang, D. M., Huang, G. Y., Lu, F. E., Stefan, D., Andreas, N., & Robert, G. (2011). Acupuncture for infertility: is it an effective therapy?. Chinese journal of integrative medicine, 17(5), 386-395.
  10. Berry, S., Seidler, K., & Neil, J. (2022). Vitamin D deficiency and female infertility: A mechanism review examining the role of vitamin D in ovulatory dysfunction as a symptom of polycystic ovary syndrome. Journal of Reproductive Immunology, 151, 103633.
  11. Bennett, M. (2001). Vitamin B12 deficiency, infertility and recurrent fetal loss. The Journal of reproductive medicine, 46(3), 209-212.
  12. Kadir, M., Hood, R. B., Mínguez-Alarcón, L., Maldonado-Cárceles, A. B., Ford, J. B., Souter, I., ... & EARTH Study Team. (2022). Folate intake and ovarian reserve among women attending a fertility center. Fertility and sterility, 117(1), 171-180.
  13. Osadchuk, L. V., Danilenko, A. D., & Osadchuk, A. V. (2021). An influence of zinc on male infertility. Urologiia, (5), 84-93.
  14. Ali, A. F., & Awadallah, A. (2003). Bee propolis versus placebo in the treatment of infertility associated with minimal or mild endometriosis: a pilot randomized controlled trial. A modern trend. Fertility and Sterility, 80, 32.
  15. Rafieian-Kopaei, M., & Movahedi, M. (2017). Systematic review of premenstrual, postmenstrual and infertility disorders of Vitex agnus castus. Electronic physician, 9(1), 3685.
  16. Raffone, E., Rizzo, P., & Benedetto, V. (2010). Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecological Endocrinology, 26(4), 275-280.
  17. Fan, C. W., Cieri-Hutcherson, N. E., & Hutcherson, T. C. (2022). Systematic review of black cohosh (Cimicifuga racemosa) for management of polycystic ovary syndrome-related infertility. Journal of Pharmacy Practice, 35(6), 991-999.

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BY DR. WILL COLE

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, Gut Feelings, and The Inflammation Spectrum.

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